{"title":"Does Superior Local Control Necessarily Indicate Oncologic Superiority in Early Hepatocellular Carcinoma?","authors":"Hamza Hussain","doi":"10.1111/liv.70842","DOIUrl":"10.1111/liv.70842","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Time-Varying Impact of Steatosis and Alcohol on Mortality: A Marginal Structural Model of the Canadian Longitudinal Study on Aging","authors":"Carmela Rapino, Giada Sebastiani, Jessica Burnside, Cindy Wen, Alnoor Ramji, Mark Swain, Keyur Patel, Sahar Saeed","doi":"10.1111/liv.70833","DOIUrl":"10.1111/liv.70833","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Subclassifications of steatotic liver disease (SLD) are intended to provide a clinically meaningful framework for management. However, steatosis, cardiometabolic comorbidities and alcohol consumption are known to change over time. We investigated the association of the dynamic classification of SLD subtypes and all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed data from the Canadian Longitudinal Study on Aging, a cohort of adults aged 45–85 years that is followed every 3 years or until death. Hepatic steatosis was identified using the NAFLD Ridge Score, and alcohol consumption was used to classify MASLD, MetALD and ALD. Marginal structural Cox proportional hazards models estimated associations between time-varying SLD subtypes and mortality. Models were adjusted for socio-demographic, lifestyle and cardiometabolic factors, and stratified by sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 16 560 participants (52.1% female; median age 58 [IQR 51–66] years), 1041 deaths occurred within a median of 7.8 years. Within the first 3 years, 35.4%, 23.7% and 22.6% of participants with ALD, MetALD and MASLD, respectively, transitioned to different SLD subtypes. Mortality risk increased with increasing levels of alcohol among people with and without steatosis, and ALD demonstrated the highest mortality risk (aHR 6.11; 95% CI 1.76–21.19). Sex-stratified analyses suggested higher mortality among females, with the highest mortality rate in females with ALD compared to males (11.37 vs. 5.60 per 1000 person-years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SLD phenotypes are dynamic, with substantial transitions between disease subtypes over time. Reliance on static classifications may therefore misclassify risk. Longitudinal, time-varying approaches better capture disease evolution and may improve prognostic assessment and risk stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Donna M. Evon, Kaya Merkler, Laura Mkumba, Nicole Lucas, Lauren Wright, Joanne Hatchett, Rachel Gomel, Patrick J. Smith, Sasha Deutsch-Link, Christopher L. Bowlus, Mark G. Swain, Bryce B. Reeve
{"title":"Fatigue and Cognitive Impairment in Adults With Primary Sclerosing Cholangitis: Results From Concept Elicitation Interviews","authors":"Donna M. Evon, Kaya Merkler, Laura Mkumba, Nicole Lucas, Lauren Wright, Joanne Hatchett, Rachel Gomel, Patrick J. Smith, Sasha Deutsch-Link, Christopher L. Bowlus, Mark G. Swain, Bryce B. Reeve","doi":"10.1111/liv.70814","DOIUrl":"10.1111/liv.70814","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>To understand the experience of fatigue and cognitive impairment in adults with symptomatic primary sclerosing cholangitis (PSC) as an essential first step towards developing PSC-specific symptom measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Purposeful sampling was used to identify 17 symptomatic adults from the PSC Symptom Assessment Project who met general trial eligibility criteria for in-depth concept elicitation interviews focused on key PSC symptoms. Of these, twelve were interviewed in-depth about fatigue and eleven about cognitive impairment. Interviews were conducted virtually, audio-recorded, transcribed and analysed. The Theory of Unpleasant Symptoms guided the development of a PSC symptom conceptual framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants were on average 42 years old, 57% male, 71% White and 57% had inflammatory bowel disease. Half experienced fatigue and cognitive impairment daily, while others described varying frequencies of these symptoms. Most participants described fatigue getting progressively worse throughout the day, often requiring naps. Fatigue interfered with domestic duties, job responsibilities and family/social activities. Fatigue impacted mental health with frustration, sadness and guilt. Participants with cognitive impairment reported it ranged from mild to severe, with some unable to live independently or maintain employment. Working memory, verbal fluency, attention and processing speed were impacted. Fatigue and cognitive impairment frequently co-occurred but could occur separately.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PSC-related fatigue and cognitive impairment impact daily, work-related, emotional and social functioning in symptomatic adults. These qualitative findings inform the customization of PSC-specific fatigue and cognitive function measures with strong content validity that is necessary for use in PSC research and clinical trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leonardo G Da Fonseca, Antonio Guerrero, Sergio G. Muñoz-Martínez
{"title":"Immunotherapy Rechallenge in HCC: A Second Chance for Response?","authors":"Leonardo G Da Fonseca, Antonio Guerrero, Sergio G. Muñoz-Martínez","doi":"10.1111/liv.70832","DOIUrl":"10.1111/liv.70832","url":null,"abstract":"<p>The therapeutic landscape of advanced hepatocellular carcinoma (HCC) has undergone a profound shift with the incorporation of immune checkpoint inhibitors (ICIs), particularly combinations such as atezolizumab-bevacizumab [<span>1</span>]. Although these regimens have redefined first-line treatment and improved survival, most patients ultimately experience disease progression. This has brought increasing attention to the post-immunotherapy setting, where decision-making remains challenging and is largely guided by limited evidence.</p><p>In current practice, multikinase inhibitors (MKIs), including sorafenib, lenvatinib, regorafenib and cabozantinib, are commonly used after ICIs. Although these agents provide a mechanistically distinct approach and have demonstrated consistent—albeit modest—activity, their role after immunotherapy is supported primarily by retrospective data and single-arm phase II trials. The progression-free survival (PFS) achieved with these drugs is around 2.8–4.1 months, with overall response rates (ORR) of < 10% by RECIST 1.1 and median overall survival (OS) below 12 months [<span>2-4</span>]. As such, the optimal sequencing strategy after ICIs failure remains undefined, and outcomes remain suboptimal for many patients.</p><p>Against this backdrop, the question of whether immunotherapy can be effectively reintroduced or maintained after prior exposure has become increasingly relevant. The use of combination regimens combining an MKI and immunotherapy yields modest results, as recently demonstrated with the combination of regorafenib plus nivolumab after atezolizumab-bevacizumab [<span>5</span>]. On the other hand, targeting complementary immune checkpoints, such as nivolumab-ipilimumab, can offer a biologically plausible strategy to overcome resistance to prior PD-(L)1–based therapy. However, data supporting this approach remain limited and concerns persist regarding both efficacy and patient selection.</p><p>In this context, the study from Kim et al. provides real-world evidence on the activity of nivolumab plus ipilimumab in advanced HCC [<span>6</span>]. This multicenter study evaluated the efficacy and safety of nivolumab plus ipilimumab in patients with advanced HCC, with a particular focus on outcomes by prior exposure to atezolizumab-bevacizumab. A total of 116 patients from six centers across Asia were included, comprising both ICI-naïve and Atezo/Bev-experienced cohorts. The primary objective was to assess treatment outcomes, including ORR, PFS and OS, and to explore factors associated with response. The ORR was 31.2%, with higher responses observed in ICI-naïve patients than in those previously treated with Ate/Bev (42.6% vs. 20.0%). The duration of response was similar between groups, suggesting the potential for durable benefit even after prior immunotherapy. Median PFS and OS were 2.5 and 11.3 months, respectively, with numerically improved outcomes in ICI-naïve patients. Notably, immune-related adverse e","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carolina Liguori, Riccardo Giampieri, Blandine Delaunay, Giada Pinterpe, Adelaide Mazzocca, Antoine Hollebecque, Jean Frederic Blanc, Mohamed Bouattour, Eric Assenat, Meher Ben Abdelghani, Matthieu Sarabi, Monica Niger, Caterina Vivaldi, Mario Mandalà, Andrea Palloni, Maria Bensi, Silvio Ken Garattini, David Tougeron, Pierre Combe, Massimiliano Salati, Margherita Rimini, Andrea Casadei-Gardini, Chiara Alessandra Cella, Marco Tucci, Anna Diana, Elena Mori, Raffaella Longarini, Pascal Artru, Gael Roth, Ludovic Evesque, Agathe Vienne, Anthony Turpin, Sandrine Hiret, Vincent Bourgeois, Camille Herve, Rodolphe Paulon, Marion Stacoffe, David Malka, Matthieu Delaye, Julien Edeline, Astrid Lievre, Rosine Guimbaud, Rita Balsano, Nadim Fares, Rossana Berardi, Alessandro Parisi
{"title":"Prognostic Impact of Concomitant Genomic Alterations in FGFR2-Positive Cholangiocarcinoma Treated With Pemigatinib.","authors":"Carolina Liguori, Riccardo Giampieri, Blandine Delaunay, Giada Pinterpe, Adelaide Mazzocca, Antoine Hollebecque, Jean Frederic Blanc, Mohamed Bouattour, Eric Assenat, Meher Ben Abdelghani, Matthieu Sarabi, Monica Niger, Caterina Vivaldi, Mario Mandalà, Andrea Palloni, Maria Bensi, Silvio Ken Garattini, David Tougeron, Pierre Combe, Massimiliano Salati, Margherita Rimini, Andrea Casadei-Gardini, Chiara Alessandra Cella, Marco Tucci, Anna Diana, Elena Mori, Raffaella Longarini, Pascal Artru, Gael Roth, Ludovic Evesque, Agathe Vienne, Anthony Turpin, Sandrine Hiret, Vincent Bourgeois, Camille Herve, Rodolphe Paulon, Marion Stacoffe, David Malka, Matthieu Delaye, Julien Edeline, Astrid Lievre, Rosine Guimbaud, Rita Balsano, Nadim Fares, Rossana Berardi, Alessandro Parisi","doi":"10.1111/liv.70813","DOIUrl":"10.1111/liv.70813","url":null,"abstract":"<p><strong>Background & aims: </strong>Anti-FGFR therapies changed the treatment landscape for patients with previously treated, advanced, or metastatic cholangiocarcinoma (CCA) harbouring FGFR2 fusions/rearrangements. However, primary resistance to FGFR inhibitors remains a key challenge. In the present real-world study, we aimed to evaluate the prognostic impact of concomitant GAs in patients with FGFR2-positive CCA treated with pemigatinib.</p><p><strong>Methods: </strong>This study included PEMIREAL-PEMIBIL patients treated with pemigatinib in second or later lines. Only patients who underwent extensive DNA- and/or RNA-based next-generation sequencing (NGS) analysis were considered. Primary endpoint was progression-free survival (PFS), with overall response rate, disease control rate and overall survival (OS) as secondary endpoint. OS and PFS were calculated by Kaplan-Meier and log-rank test. Multivariate analysis used cox-regression model. Level of statistical significance p was 0.05.</p><p><strong>Results: </strong>Of 72 patients of PEMIREAL-PEMIBIL, 63 patients had evaluable NGS data, with concomitant GAs identified in 28 patients (44.4%). The most frequently observed concomitant GAs involved BAP1 (7/63, 11.1%), CDKN2A (7/63, 11.1%), TP53 (6/63, 9.5%), CDKN2B (5/63, 7.9%), PTEN (3/63, 4.7%) and IDH1 (1/63, 1.5%). A significantly shorter PFS was observed in patients with CDKN2A mutations compared to CDKN2A wild-type tumours (4.79 vs. 8.66 months, p = 0.0011, HR: 3.48 95% CI: 0.91-13.24), and similarly in patients with BAP1 mutations compared to BAP1 wild-type tumours (5.97 vs. 8.52 months, p = 0.025, HR:2.55 95% CI: 0.72-9.00). No significant differences in OS were observed.</p><p><strong>Conclusions: </strong>Our results support the negative prognostic role of BAP1 and CDKN2A GAs on PFS in patients with locally advanced or metastatic CCA with FGFR2 gene fusion/rearrangement treated with pemigatinib in a real-world setting.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70813"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Elisa Buitrago-Molina, Matthias Hardtke-Wolenski
{"title":"Experimental Models of Autoimmune Hepatitis: Disease Fidelity and Translational Relevance.","authors":"Laura Elisa Buitrago-Molina, Matthias Hardtke-Wolenski","doi":"10.1111/liv.70797","DOIUrl":"10.1111/liv.70797","url":null,"abstract":"<p><p>Autoimmune hepatitis (AIH) remains difficult to study mechanistically in patients because disease initiation is rarely observed directly, the relevant autoantigens differ across subsets, and clinically meaningful outcomes such as chronic inflammation, fibrosis, relapse, and treatment response evolve over time. Animal models therefore remain indispensable. At the same time, the field has become increasingly heterogeneous. Acute immune-mediated hepatitis systems, especially concanavalin A (ConA), dominate the recent literature because they are rapid, inexpensive, and experimentally tractable. However, ConA-induced hepatitis is not an antigen-driven autoimmune response and is better interpreted as acute bystander immune-mediated liver injury than as a stand-alone model of chronic AIH. In contrast, antigen-driven adenoviral models based on cytochrome P450 2D6 (CYP2D6) or formiminotransferase cyclodeaminase (FTCD), as well as genetically predisposed or spontaneous tolerance-defect models, provide stronger insight into loss of hepatic tolerance, chronicity, fibrosis, and the interaction between antigenic context and host susceptibility. This review proposes a pragmatic framework for evaluating AIH models on the basis of face validity, construct validity, predictive validity, chronicity, host susceptibility, and mechanistic fitness for a specific biological question. Using that framework, we classify current models into acute surrogate models, immunization- and xenoantigen-based systems, adenoviral antigen-driven chronic models, spontaneous and genetically predisposed models, transgenic or neoantigen-driven tolerance models, and humanized or microbiota-sensitive hybrid systems. We then synthesize what these systems have taught the field about central and peripheral tolerance, MHC and non-MHC genetic susceptibility, sex- and age-related disease context, CD4<sup>+</sup> and CD8<sup>+</sup> T-cell biology, B-cell function, regulatory T-cell instability, impaired suppressive function, defective IL-2-dependent regulation, macrophage and innate lymphocyte participation, cell-death programmes, and gut-liver or liver-microbiome interactions. A central conclusion emerges: AIH models are complementary tools with markedly different levels of disease fidelity, and they should not be treated as interchangeable. Acute systems remain useful for effector-phase biology and first-pass intervention studies, but the strongest translational inferences for chronic AIH come from antigen-defined chronic models and selected tolerance-defect systems. Future progress will depend on better benchmarking across models, stronger alignment with human immune profiling and ex vivo validation platforms, and wider use of tolerance-restoring rather than purely anti-inflammatory therapeutic strategies.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70797"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Henar Calvo-Sánchez, Lorena Jara-Fernández, Raquel Encijo-Heredia, Irene Villarino, Rubén Alvarado, Marta Quiñones-Calvo, María-Luisa Gutiérrez, Joaquín Miquel, Miguel Torralba, Myriam Catalá, José Gómez, Sonia Albertos, Óscar Barquero-Pérez, Conrado Fernández-Rodríguez, Juan-Ramón Larrubia
{"title":"Cumulative Metformin Use and Hepatocellular Carcinoma Risk After HCV SVR: A Multicentre Cohort Study.","authors":"Henar Calvo-Sánchez, Lorena Jara-Fernández, Raquel Encijo-Heredia, Irene Villarino, Rubén Alvarado, Marta Quiñones-Calvo, María-Luisa Gutiérrez, Joaquín Miquel, Miguel Torralba, Myriam Catalá, José Gómez, Sonia Albertos, Óscar Barquero-Pérez, Conrado Fernández-Rodríguez, Juan-Ramón Larrubia","doi":"10.1111/liv.70798","DOIUrl":"10.1111/liv.70798","url":null,"abstract":"<p><strong>Background: </strong>Although sustained virological response (SVR) after hepatitis C virus treatment reduces hepatocellular carcinoma (HCC) incidence, residual risk persists. Metformin has been associated with lower HCC risk, but whether cumulative metformin exposure (CME) lowers post-SVR risk remains unclear. We evaluated whether CME was associated with lower HCC risk after SVR.</p><p><strong>Methods: </strong>We analysed a multicentre cohort of 1531 patients who achieved SVR after direct-acting antiviral therapy (median follow-up, 75.5 months). Metformin exposure was modelled as a time-updated cumulative variable in start-stop Cox models to control for immortal-time bias. Stabilised inverse probability weighting addressed confounding by indication and censoring. The overall model was sex-stratified and adjusted for FIB-4, clinically significant portal hypertension (CSPH), type 2 diabetes mellitus (T2DM) and smoking. A prespecified T2DM-restricted analysis used T2DM-specific IPTW plus IPCW, sex stratification and CSPH adjustment.</p><p><strong>Results: </strong>During follow-up, 50 patients developed HCC. Crude incidence was highest among patients with FIB-4 > 3.25, CSPH and T2DM without metformin exposure (4.84 cases per 100 person-years). In the overall weighted model, CME was associated with lower HCC risk (HR, 0.46 per year; 95% CI, 0.27-0.77; p = 0.004). CSPH, T2DM, smoking and FIB-4 > 3.25 independently increased risk. In the T2DM-restricted model, each additional year remained associated with lower HCC hazard (HR, 0.49; 95% CI, 0.29-0.84; p = 0.009), whereas CSPH was associated with higher risk (HR, 6.04; 95% CI, 2.12-17.19; p < 0.001).</p><p><strong>Conclusion: </strong>After SVR, CME was associated with lower HCC risk; this possible duration-dependent inverse association was clinically interpretable only among metformin-eligible patients with T2DM.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70798"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to 'The Genetics of Portal Hypertension: Recent Developments and the Road Ahead'.","authors":"","doi":"10.1111/liv.70787","DOIUrl":"10.1111/liv.70787","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70787"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}